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(Li Dongyuan)

Treats Zhongman (Middle Fullness) and Drum Distension, Qi Distension, Water Distension, and Heat Distension. (Various diseases manifest with sounds; striking the abdomen produces a drum-like sound, which is called Drum Distension. When Qi mechanism is not free-flowing, it is called Qi Distension; when Blood circulation is not free-flowing, it is called Blood Distension; if only the Qi aspect is affected causing hardness and distension below the heart with pathology originating in the upper jiao, while Blood aspect pathology involves blood stasis at the Bao Gate (uterus/pelvis) with pathology originating in the lower jiao; when both Qi and Blood are obstructed, then Water metabolism is also obstructed leading to distension. The *Jin Gui Yao Lue* states: What are Blood Distinction and Water Distinction? The Master said...)

Cortex Magnoliae Officinalis (Choupu, stir-fried, 1 liang), Fructus Aurantii Immaturus (Zhishi, stir-fried), Rhizoma Coptidis (Huanglian, stir-fried), Radix Scutellariae (Huangqin), Rhizoma Pinelliae Preparatum (Banxia, prepared with ginger juice, 5 qian), Pericarpium Citri Reticulatae (Chenpi), Rhizoma Anemarrhenae (Zhimu, stir-fried), Radix Glycyrrhizae Preparata (Gancao, honey-fried), Sclerotium Poriae Cocos (Zhuling, 1 qian). Form into pills using steamed wheat cake dough. Take warm after baking. (Use cold natured herbs for heat conditions [Han Yin Re Yong]. Li Dongyuan established Zhongman Fenxiao Wan to treat Heat Distension, and Fenxiao Tang to treat Cold Distension; distinguish between the two and use accordingly.)

This prescription acts on the Foot-Taiyin Spleen Meridian and Foot-Yangming Stomach Meridian. Cortex Magnoliae Officinalis (Choupu) and Fructus Aurantii Immaturus (Zhishi) promote Qi movement and dissipate fullness; these two herbs also possess the ability to break up old Blood stasis. Rhizoma Coptidis (Huanglian) and Radix Scutellariae (Huangqin) drain Heat and dissipate epigastric stuffiness... [Text fragment] ...then the distension will subside. (Note: This formula combines Liu Jun Zi Tang (Six Gentlemen Decoction), Si Ling San (Four Porias Powder), Xie Xin Tang (Drain the Epigastrium Decoction), Er Chen Tang (Two Aged Herbs Decoction), and Ping Wei San (Maintain the Stomach Powder) into one prescription. The differences lie in the dosages, determining whether the treatment targets the primary or secondary condition. Zhu Danxi said: The Spleen possesses the virtue of Kun (Earth/Stillness) but has the function of Qian (Heaven/Movement). Thus, it can cause the Yang of Heart and Lung to descend and the Yin of Liver and Kidney to ascend, achieving the state of Heaven and Earth interacting (Tai), which constitutes a healthy person. Currently, internal injury from Seven Emotions, external invasion by Six Excesses, irregular diet, and sexual exhaustion causing deficiency, all injure the Yin of Spleen Earth. The official responsible for transport and transformation loses its duty, causing Yang to rise and Yin to fall, resulting in the state of Pi (Stagnation/Non-interaction) where Heaven and Earth do not communicate. Clear and turbid Qi mix, meridians and collaterals become blocked and stagnant, generating Heat. Heat lingering transforms into Dampness. Dampness and Heat generate each other, eventually forming distension. The Classics call this Drum Distension. Because the exterior appears hard and full while the interior is empty, resembling a drum; and because it is stubborn and difficult to treat, it is also named Gu (Poisonous Worm), implying erosion like insects. One should tonify the Spleen, nourish Lung Metal to control Water, so the Spleen is free from thief pathogens; nourish Kidney Yin to control Fire, so the Lung receives the command of clear transformation. Abstain from salty flavors, cut off delusions, and there will be no unrest. Physicians eager for quick results, patients...)